Ustekinumab in the Treatment of Generalized Pustular Psoriasis in a Pregnant Patient

乌斯特基努马 医学 皮疹 银屑病 皮肤病科 中止 怀孕 泛发性脓疱性银屑病 外科 内科学 疾病 英夫利昔单抗 生物 遗传学
作者
Hao Wu,Yan Shen,Zhongxiao Wu,Feng Mao,Yiming Ren,Li Zhang
出处
期刊:Clinical, Cosmetic and Investigational Dermatology [Dove Medical Press]
卷期号:Volume 17: 1107-1110
标识
DOI:10.2147/ccid.s451738
摘要

Abstract: Although the use of biologics has led to great improvement in psoriasis patients, the treatment of psoriasis during pregnancy still faces many challenges. We herein report on a 29-year-old pregnant woman treated with ustekinumab for generalized pustular psoriasis. Upon becoming pregnant, the woman underwent continued treatment with ustekinumab in the first trimester. We also considered the need for neonatal vaccination. The patient discontinued ustekinumab therapy in the second trimester, and during the period of drug discontinuation we noted a slight rash recurrence. The patient was treated with ultraviolet B phototherapy and topical corticosteroids, and the rash was localized to the abdomen. However, in the 27th week of pregnancy, the patient was infected with COVID-19, which made the condition worse. The rash erupted rapidly and spread throughout her body, and she experienced a high fever with her blood count showing augmented numbers of white blood cells. The patients self-administered 0.3 g of acetaminophen three times per day, and after four days her core body temperature was 38.0°C; the rash, however, did not diminish. We diagnosed an outbreak of generalized pustular psoriasis and treated the patient with ustekinumab. The rash resolved quickly, and a healthy newborn was delivered by caesarean section at 39 weeks. Keywords: Ustekinumab, interleukin-12/-23, generalized pustular psoriasis, pregnancy, COVID-19

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